- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $572.65 / $8,783.00 / $16,639.00
| Facility | | $572.65 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,347.39 / $5,205.85 / $8,724.34
| Facility | | $2,347.39 | $5,205.85 | $8,724.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $571.42 / $890.00 / $2,581.96
| Facility | | $571.42 | $890.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $521.66 / $678.77 / $1,114.88
| Facility | | $521.66 | $678.77 | $1,114.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $10,257.00 / $16,249.00
| Facility | | $1,550.00 | $10,257.00 | $16,249.00 |